Coronary Plaque Regression and Lifestyle Modification in Patients Treated With Pravastatin – Assessment Mainly by Daily Aerobic Exercise and an Increase in the Serum Level of High-Density Lipoprotein Cholesterol –

Shigemasa Tani; Ken Nagao; Takeo Anazawa; Hirofumi Kawamata; Shingo Furuya; Hiroshi Takahashi; Kiyoshi Iida; Michiaki Matsumoto; Takehiko Washio; Narimichi Kumabe; Atsushi Hirayama

doi:10.1253/circj.CJ-09-0705

Ischemic Heart Disease

Coronary Plaque Regression and Lifestyle Modification in Patients Treated With Pravastatin

– Assessment Mainly by Daily Aerobic Exercise and an Increase in the Serum Level of High-Density Lipoprotein Cholesterol –

Shigemasa Tani, Ken Nagao, Takeo Anazawa, Hirofumi Kawamata, Shingo Furuya, Hiroshi Takahashi, Kiyoshi Iida, Michiaki Matsumoto, Takehiko Washio, Narimichi Kumabe, Atsushi Hirayama

Author information

Shigemasa Tani
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Ken Nagao
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Takeo Anazawa
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Hirofumi Kawamata
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Shingo Furuya
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Hiroshi Takahashi
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Kiyoshi Iida
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Michiaki Matsumoto
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Takehiko Washio
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Narimichi Kumabe
Department of Cardiology, Nihon University Surugadai Hospital
Division of Cardiology, Department of Medicine, Nihon University School of Medicine
Atsushi Hirayama
Division of Cardiology, Department of Medicine, Nihon University School of Medicine

Keywords: Atherosclerosis, Coronary artery disease, Lifestyle, Lipids, Statins

JOURNAL FREE ACCESS

2010 Volume 74 Issue 5 Pages 954-961

DOI https://doi.org/10.1253/circj.CJ-09-0705

View "Advance Publication" version (March 17, 2010).

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Abstract

Background: The purpose of this study was to explore the effect of lifestyle modification, mainly daily aerobic exercise, on coronary atherosclerosis in patients with coronary artery disease (CAD). Methods and Results: A 6-month prospective observational study was conducted with 84 CAD patients receiving pravastatin treatment in order to evaluate the relationship between lifestyle modification, in particular aerobic exercise, and plaque volume as assessed by intravascular ultrasound (IVUS). Lifestyle during the study period was assessed by the-lifestyle modification score. A significant decrease in plaque volume by 12.9% was observed after 6 months of pravastatin therapy (P<0.0001 vs baseline). The change in plaque volume correlated with the change in the serum level of high-density lipoprotein cholesterol (HDL-C) (r=-0.549, P<0.0001), non-HDL-C (r=0.248, P=0.03), low-density lipoprotein cholesterol/HDL-C (r=0.505, P<0.0001), apolipoprotein (apo) A-1 (r=-0.335, P=0.007) and apoB/apoA-1 (r=0.335, P=0.007), and lifestyle modification score (r=-0.616, P<0.0001). There was a clear positive correlation between a change in the serum HDL-C level and lifestyle modification score. Multivariate regression analysis revealed that the increase in serum HDL-C level and lifestyle modification score were independent predictors of coronary plaque regression. Conclusions: An appropriate combination of statin therapy and lifestyle modification, in particular, physical activity, may result in coronary plaque regression. This combined treatment strategy, inducing an increase of the serum HDL-C, may contribute to coronary plaque regression. (Circ J 2010; 74: 954 - 961)

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